Interagency Agreement Between The USDI, Bureau Of Indian Affairs ...
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United States Government Interagency Agreement (IAA) – Agreement Between Federal Agencies Order Requirements and Funding Information (Order) Section IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________ FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE Page 1 of 5 Form 04/12 PRIMARY ORGANIZATION/OFFICE INFORMATION 24. Requesting Agency Servicing Agency Primary Organization/Office Name Responsible Organization/Office Address ORDER/REQUIREMENTS INFORMATION 25. Order Action (Check One) New Modification (Mod) – List affected Order blocks being changed and explains the changes being made. For Example: for a performance period mod, state new performance period for this Order in Block 27. Fill out the Funding Modification Summary by Line (Block 26) if the mod involves adding, deleting or changing Funding for an Order Line. Cancellation – Provide a brief explanation for Order cancellation and fill in the Performance Period End Date for the effective cancellation date. 26. Funding Modification Summary by Line Line # ______ Line # _____ Line # ______ Total of All Other Lines (attach funding details) Total Original Line Funding Cumulative Funding Changes From Prior Mods [addition (+) or reduction (-)] Funding Change for This Mod TOTAL Modified Obligation Total Advance Amount (-) Net Modified Amount Due 27. Performance Period Start Date End Date For a performance period mod, insert the start and end dates that reflect the new performance period. MM-DD-YYYY MM-DD-YYYY
Transcript of United States Government Interagency Agreement (IAA ... · PDF fileUnited States Government...
United States Government Interagency Agreement (IAA) – Agreement Between Federal Agencies
Order Requirements and Funding Information (Order) Section
IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________
FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE Page 1 of 5
Form 04/12
PRIMARY ORGANIZATION/OFFICE INFORMATION
24. Requesting Agency Servicing Agency Primary Organization/Office Name
Responsible Organization/Office Address
ORDER/REQUIREMENTS INFORMATION
25. Order Action (Check One)
New
Modification (Mod) – List affected Order blocks being changed and explains the changes being made. For Example: for a performance period mod, state new performance period for this Order in Block 27. Fill out the Funding Modification Summary by Line (Block 26) if the mod involves adding, deleting or changing Funding for an Order Line.
Cancellation – Provide a brief explanation for Order cancellation and fill in the Performance Period End Date for the effective cancellation date.
26. Funding Modification Summary by Line
Line # ______ Line # _____ Line # ______
Total of All Other Lines
(attach funding details)
Total
Original Line Funding Cumulative Funding Changes From Prior Mods [addition (+) or reduction (-)]
Funding Change for This Mod TOTAL Modified Obligation
Total Advance Amount (-) Net Modified Amount Due 27. Performance Period Start Date End Date For a performance period mod, insert the start and end dates that reflect the new performance period.
MM-DD-YYYY MM-DD-YYYY
Sticky Note
• Use for new agreements to establish Performance Period. • Use for modification when changing any part of the Performance Period. • Fill in Performance Period End Date for cancellations and/or terminations. • The Performance Period identifies the dates between which the products and/or services for the Order will be provided. • The Performance Period could include the Servicing Agency’s activities to prepare for and closeout the delivery of the requested products/services. • The Performance Period will be defined depending on the business needs for each IAA. • For a performance period mod, insert the start and end dates that reflect the new performance period.
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• Use to deobligate and close the agreement plus any additional documentation in accordance with the agencies guidance for close-out (FS-6500-235 or FS-6500-243 for Forest Service). • List the affected Order blocks being changed and explain the changes being made. For Example: For a modification to change the performance period, state new performance period in Block 27. • Fill out the Funding Modification Summary by Line (Block 26) if the Mod involves adding, deleting, or changing funding for an Order Line. • A Mod number must be entered in the IAA Number schema. • Signature requirement is specified in the Signatures and Contacts section below.
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• Check if this Order is being canceled and provide a brief explanation. • Fill in the Performance Period End date for the effective cancellation date.
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Interagency Agreement (IAA) - Order Instructions Updated April 10, 2012 Order Requirements and Funding Information (Order) [7600B] The Order is the funding section that creates a fiscal obligation when the Requesting Agency demonstrates a bona fide need and provides the necessary product(s)/service(s) requirements; funding information is provided for both trading partners; and all required points of contact sign to authorize the Order. The Order identifies the specific Requesting Agency requirements for the expected delivery of products and/or services by the Servicing Agency. This section identifies the roles and responsibilities for both trading partners to ensure effective management of the Order and use of the related funds. Agency/Trading Partners should refer to the following documents to develop standard Governmentwide business practices for their reimbursable activity: the Treasury Financial Manual (TFM) Volume I, Intragovernmental Business Rules Bulletin - HYPERLINK http://www.fms.treas.gov/finstandard/reference.html http://www.fms.treas.gov/finstandard/reference.html and, the Financial Management Line of Business (FMLoB), Standard Business Processes Document V 1.2, Chapter 5.0 - Reimbursables Management Processes - http://www.fms.treas.gov/finstandard/reference.html Service First specific instructions: 1. After extensive interagency review, there are several blocks of this form that were determined to be either option or not applicable. The following color coding scheme was developed to indicate to users what information is required, optional, and not necessary: Color Status GREEN Required YELLOW Optional (these may be optional to all agencies, optional to one and required by another, or the information is captured elsewhere in the agreements process and putting it on this form represents a duplication of work). RED Not Necessary (where applicable, an explanation is provided in italics). 2. If a field is required by one agency and not another, then that is noted under the field name. 3. Agencies shall send an editable version of the IAA form, articles and attachments in advance (Contracting Officer, Budget, Program and Grants Management Specialist) allowing for edits to the document before finalizing for signature. This will help ensure correct information has been provided. 4. Require signature to be that of the delegated official for that agency (example: Contracting Officer, Forest Supervisor, Requesting Agencies Funding Official). All other signatures are optional.
IAA Order
IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________
FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE
Page 2 of 5
Form 04/12
28. Order Line/Funding Information Line Number __________
Requesting Agency Funding Information
Servicing Agency Funding Information
ALC Component TAS Requiredby 10/1/2014
SP ATA AID BPOA EPOA A MAIN SUB SP ATA AID BPOA E POA A MAIN SUB
and/or Current TAS format
BETC Object Class Code (Optional) BPN BPN + 4 (Optional) Additional Accounting Classification/Information (Optional) Requesting Agency Funding Expiration Date ______________ MM-DD-YYYY
Requesting Agency Funding Cancellation Date ______________ MM-DD-YYYY
Project Number & Title Description of Products and/or Services, including the Bona Fide Need for this Order (State or attach a description of products/services, including the bona fide need for this Order.)
North American Industry Classification System (NAICS) Number (Optional) _______________________________________ Breakdown of Reimbursable Line Costs and/or Breakdown of Assisted Acquisition Line Cost: Unit of Measure Contract Cost
Quantity Unit Price Total Servicing Fees
Total Obligated Cost
Overhead Fees & Charges Advance for Line (-) Total Line Amount Obligated
Net Total Cost
Assisted Acquisition Servicing Fees Explanation Advance Line Amount (-)
Net Line Amount Due
Type of Service Requirements
Severable Service Non-severable Service Not Applicable
Sticky Note
Enter the Requesting Agency’s and Servicing Agency’s Location Code (See http://www.fms.treas.gov/TFM/vol1/v1p2c330.html). Use these codes for each agency: US Fish & Wildlife Service ->14-16-0006 US Forest Service ->12-40-1100 Bureau of Land Management ->14-11-0008 National Park Service ->14-10-0099
Sticky Note
Agency must enter either the current TAS format for the Requesting Agency and Servicing Agency. http://www.fms.treas.gov/cars/factsheet_tas.html Agency must enter TAS in the current format for the Requesting Agency and Servicing Agency. If more than one TAS, identify on one line separated by a comma. If Forest Service is the Servicing Agency (incoming) the TAS will either be 12X1103, 12X1106, or 12X1115. If Forest Service is the Requesting Agency (outgoing) TAS can be found in NRM.
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For each line, enter the Object Class Code. US Fish & Wildlife Service -> NOT mandatory US Forest Service -> Mandatory for outgoing funds Bureau of Land Management -> NOT mandatory National Park Service -> NOT mandatory
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Enter the Requesting Agency’s and Servicing Agency’s DUNS number. US Forest Service -> 92-9332484 US Fish & Wildlife Service -> The local Contracting Office will have this information Bureau of Land Management -> The local Contracting Office will have this information National Park Service -> The local Contracting Office will have this information
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Enter additional important accounting information used for internal tracking for the Requesting Agency and/or Servicing Agency. If Forest Service is the Requesting Agency reference the FMMI DOC ID# found in NRM.
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Select Severable, Non-severable Service, or Not Applicable for this Order Line. Severable: Those projects that are continuing and recurring in nature. Must be funded from the appropriation available during the fiscal year of performance. Non-Severable: Those projects that constitute an entire job or single undertaking with a defined end-product that cannot feasibly be subdivided for separate performance in a fiscal year. Must be funded entirely out of the appropriation current at the time of award. Performance can cross over to another fiscal year. Assisted Acquisition: When a requesting agency receives goods or services from a servicing agency through a contractor (supply, service or construction project) (example: BLM requests that FS purchase and install a security system on a FS owned/leased collocated building; each agency contributes funds towards the acquisition of this supply). The requesting agency initiates an interagency agreement to obligate funds for this acquisition. The servicing agency completed the acquisition and bills the requesting agency for the agreed upon share or amount.
IAA Order
IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________
FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE
Page 3 of 5
Form 04/12
BILLING & PAYMENT INFORMATION
32. Payment Method (Check One) [Intra-governmental Payment and Collection (IPAC) is the Preferred Method.] If IPAC is used, the payment method must agree with the IPAC Trading Partner Agreement (TPA).
Requesting Agency Initiated IPAC Servicing Agency Initiated IPAC
Credit Card Other – Explain other payment method and reasoning ______________________
33. Billing Frequency (Check One)
[An Invoice must be submitted by the Servicing Agency and accepted by the Requesting Agency BEFORE funds are reimbursed (i.e., via IPAC transaction)]
Monthly Quarterly Other Billing Frequency (include explanation)____________________________________
34. Payment Terms (Check One)
7 days Other Payment Terms (include explanation): ___________________________________________________
29. Advance Information (Complete Block 29 if the Advance Payment for Products/Services was checked “Yes” on the GT&C.)
Total Advance Amount for the Order $_________________________ [All Order Line advance amounts (Block 28) must sum to this total.]
Revenue Recognition Methodology (according to SFFAS 7) (Identify the Revenue Recognition Methodology that will be used to account for the Requesting Agency’s expense and the Servicing Agency’s revenue) Straight-line – Provide amount to be accrued $_________________ and Number of Months _______
Accrual Per Work Completed – Identify the accounting posting period:
Monthly per work completed & invoiced
Other – Explain other regular period (bimonthly, quarterly, etc.) for posting accruals and how the accrual amounts will be communicated if other than billed.
30. Total Net Order Amount: $______________________________ [All Order Line Net Amounts Due for reimbursable agreements and Net Total Costs for Assisted Acquisition Agreements (Block 28) must sum to this total.] 31. Attachments (State or list attachments.)
Key project and/or acquisition milestones (Optional except for Assisted Acquisition Agreements)
Other Attachments (Optional)
Sticky Note
Intra-governmental Payment and Collection (IPAC) is the preferred method. If IPAC is used, the payment method must agree with the Master Interagency Service First Agreement.
IAA Order
IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________
FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE
Page 4 of 5
Form 04/12
35. Funding Clauses/Instructions (Optional) (State and/or list funding clauses/instructions.)
36. Delivery/Shipping Information for Products (Optional) Agency Name
Point of Contact (POC) Name & Title
POC Email Address
Delivery Address /Room Number
POC Telephone Number
Special Shipping Information
APPROVALS AND CONTACT INFORMATION
37. AUTHORIZED REPRESENTATIVE – Signature Required.The Authorized Representative(s), as identified by the Requesting Agency and Servicing Agency, must ensure that the scope of work is properly defined and can be fulfilled for this Order. The Authorized Representative(s) may or may not be the Contracting Officer depending on each agency’s IAA business process. Requesting Agency Servicing Agency Name
Title
Telephone Number
Fax Number
Email Address
SIGNATURE
Date Signed
38. TECHNICAL POINT OF CONTACT (TPOC): Signature OptionalThe TPOC, as identified by the Requesting Agency and Servicing Agency, must ensure that the scope of work is properly defined and can be fulfilled for this Order.
Requesting Agency Servicing Agency Name
Title
Telephone Number
Fax Number
Email Address
SIGNATURE
Date Signed
Sticky Note
Enter the Agency Name, Point of Contact (POC) Name & Title, Email Address, Delivery Address/Room Number, and POC Telephone Number of the person who will receive the shipment.
Sticky Note
Authorized Representative will sign only after review of the statement of work and only if they can assure that the scope of work is defined and can be fulfilled. The Authorized Representative(s), as identified by the Requesting Agency and Servicing Agency, must ensure that the scope of work is properly defined and can be fulfilled for this Order. The Authorized Representative(s) may or may not be the Contracting Officer depending on each agency’s IAA business process. By signature below, each party certifies that the individuals listed in this document as representatives of the individual parties are authorized to act in their respective areas for matters related to this instrument. By signing this document, the Requesting Agency Authorized Representative(s) confirms that a bona fide need exists and that funds are legally available for the acquisition described in this document. By then signing this document, the Servicing Agency Authorized Representative(s) accepts the Order’s terms and conditions and confirms that the scope of work can be fulfilled.
Sticky Note
The TPOC, as identified by the Requesting Agency and Servicing Agency, must ensure that the scope of work is properly defined and can be fulfilled for this Order.
Sticky Note
The Technical Point of Contact for the Requesting Agency may sign to certify that the scope of work is defined and the order can be fulfilled for this Interagency Agreement. The Technical Point of Contact for the Servicing Agency may sign to certify that the scope of work is defined and the order can be fulfilled for this Interagency Agreement.
IAA Order
IAA Number __________________ - _______ - ________________ Servicing Agency’s Agreement GT&C # Order # Amendment/Mod # Tracking Number (Optional) __________________
FMS 7600B DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE
Page 5 of 5
Form 04/12
CONTACT INFORMATION
FINANCE OFFICE Points of Contact (POCs) The finance office points of contact ensure that the payment (Requesting Agency), billing (Servicing Agency), and advance/accounting information are accurate and timely for this Order.
39. Requesting Agency (Payment Office) Servicing Agency (Billing Office) Name Title Office Address
Telephone Number
Fax Number
Email Address
Signature & Date (Optional)
40. ADDITIONAL Points of Contacts (POCs) (as determined by each Agency) This may include CONTRACTING Office Points of Contact (POCs).
Requesting Agency Servicing Agency Name Title Office Address
Telephone Number Fax Number Email Address Signature & Date (Optional)
Name Title Office Address
Telephone Number Fax Number Email Address Signature & Date (Optional) Name Title Office Address
Telephone Number Fax Number Email Address Signature & Date (Optional)
Sticky Note
The Finance Office POCs for both the Requesting Agency and the Servicing Agency ensure that the payment (Requesting Agency), billing (Servicing Agency), and accounting information are accurate and timely for this Order. The appropriate FPOC in the organization is determined differently by each agency; preferably this is someone at the local level who is familiar with the budget & finances of the units involved.
Sticky Note
The Finance Office Point of Contact for the Requesting Agency may sign to certify that the scope of work is defined and the order can be fulfilled for this Interagency Agreement. The Finance Point of Contact for the Servicing Agency may sign to certify that the scope of work is defined and the order can be fulfilled for this Interagency Agreement.
Sticky Note
For Example: Grants Management Spec.; Technical POC; Admin Contacts, Budget Officer
